Patient outcomes in context of documentation

ABSTRACT

Outcomes from a patient plan of care are provided in conjunction with documentation of patient assessment items to assist clinicians in the healthcare process. A documentation area for documenting assessment items for a patient and having areas for entering patient assessment information is presented. Additionally, an outcome icon is presented in conjunction with at least one assessment item. The outcome icon relates to at least one outcome corresponding with the assessment item and is based on the patient plan of care. In response to receiving a user selection of the outcome icon, information associated with the outcome is presented in context of the documentation area.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.60/828,531 filed Oct. 6, 2006. Additionally, this application is relatedby subject matter to the invention disclosed in the following U.S.patent applications filed on even date herewith: U.S. application Ser.No. (not yet assigned) (Attorney Docket Number CRNI.129817), entitled“Patient Activity Coordinator;” U.S. application Ser. No. (not yetassigned) (Attorney Docket Number CRNI.129819), entitled “ProvidingClinical Activity Details in Context;” U.S. application Ser. No. (notyet assigned) (Attorney Docket Number CRNI.132713), entitled “ProvidingMultidisciplinary Activities in Context of Clinician's Role RelevantActivities;” U.S. application Ser. No. (not yet assigned) (AttorneyDocket Number CRNI.132714), entitled “Rescheduling Clinical Activitiesin Context of Activities View;” U.S. application Ser. No. (not yetassigned) (Attorney Docket Number CRNI.132715), entitled “ViewingClinical Activity Details within a Selected Time Period;” U.S.application Ser. No. (not yet assigned) (Attorney Docket NumberCRNI.132716), entitled “Document of Medication Activities in Context ofMAR;” U.S. application Ser. No. (not yet assigned) (Attorney DocketNumber CRNI.132717), entitled “Acknowledgement of Previous Results forMedication Administration;” U.S. application Ser. No. (not yet assigned)(Attorney Docket Number CRNI.132718), entitled “Clinical ActivityNavigator;” each of which is assigned or under obligation of assignmentto the same entity as this application, and incorporated in thisapplication by reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

BACKGROUND

Clinicians in many healthcare organizations are more frequently beingtasked to treat a greater number of patients. Additionally, cliniciansmust often perform a wide variety of care-related activities for each oftheir patients. These activities are typically based on a clinician'srole. For example, activities for a nurse may include administeringmedications, performing patient assessments, collecting specimens frompatients, and providing general patient care. Given the increased numberof patients that clinicians are treating, it is often difficult forclinicians to manage the various activities associated with each oftheir patients. This increased case load and the accompanying stress canresult in a greater number of medical errors.

A variety of computer-based solutions have been developed to assistclinicians in the care of patients. Such solutions provide clinicianswith access to patient information and allow clinicians to managepatient activities. However, many of these solutions have not been wellconstructed. In particular, some solutions present too much informationto the clinician, forcing the clinician to sift through the data to finddesired information. This can be a time-consuming process forclinicians. As a result, many clinicians resort to a manual process ofrecording the most vital patient information, for example, on a notecard that they carry around with them.

In some cases, current computer-based solutions require clinicians tomove between various different applications to find patient information,view activities, and document completion of activities. As such,clinicians typically cannot maintain a context of the activities theyneed to perform during a particular shift. Further, if clinicians areinterrupted while performing a workflow using a current solution, theclinician typically must start the workflow from the beginning whenreturning to complete the workflow.

BRIEF SUMMARY

This summary is provided to introduce a selection of concepts in asimplified form that are further described below in the DetailedDescription. This summary is not intended to identify key features oressential features of the claimed subject matter, nor is it intended tobe used as an aid in determining the scope of the claimed subjectmatter.

Embodiments of the present invention relate to facilitating cliniciansin the management of patient activities. A patient activity list may beprovided with a common view that allows a clinician to review assignedpatients and activities for a work period. The patient activity listlimits the amount of information presented but is fully navigable toallow the clinician to access further information and completeactivities within context of the clinician's activities. Additionally,an activities navigator manages the completion of activities selected bya clinician.

Accordingly, in one aspect, an embodiment of the invention is directedto a method for providing outcome information associated with a patientplan of care in conjunction with documentation of assessment items for apatient. The method includes presenting a documentation area fordocumenting one or more assessment items for the patient, thedocumentation area having one or more areas for entering patientassessment information for the one or more assessment items. The methodalso includes presenting an outcome icon in conjunction with at leastone assessment item, the outcome icon relating to at least one outcomecorresponding with the at least one assessment item and being based onthe patient plan of care. The method further includes receiving a userselection of the outcome icon. The method still further includespresenting information associated with the at least one outcome incontext of the documentation area.

In another embodiment, an aspect of the invention is directed to one ormore computer-readable media embodying computer-useable instructions forperforming a method for facilitating documentation of patient assessmentitems. The method includes identifying an outcome from a patient plan ofcare corresponding with a patient assessment item requiringdocumentation for the patient. The method also includes providinginformation associated with the outcome in context of documentation ofthe patient assessment item.

A further embodiment of the invention is directed to a method in aclinical computing environment for determining whether an outcome from apatient plan of care has been met for a patient. The method includesreceiving patient assessment information for a patient assessment item.The method also includes comparing the patient assessment informationagainst one or more outcomes from a patient plan of care. The methodfurther includes determining whether each outcome has been met andpresenting an indication whether each outcome has been met.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

The present invention is described in detail below with reference to theattached drawing figures, wherein:

FIG. 1 is a block diagram of an exemplary computing environment suitablefor use in implementing the present invention;

FIG. 2 is an illustrative screen display showing an exemplary patientactivity list in accordance with an embodiment of the present invention;

FIG. 3 is an illustrative screen display showing an exemplary patientactivity list with a critical indicators window in accordance with anembodiment of the present invention;

FIG. 4 is an illustrative screen display showing an exemplary patientactivity list with a patient snapshot in accordance with an embodimentof the present invention;

FIG. 5 is an illustrative screen display showing a patient chartaccessed from a patient activity list in accordance with an embodimentof the present invention;

FIG. 6 is an illustrative screen display showing an inbox accessed froma key notification on a patient activity list in accordance with anembodiment of the present invention;

FIG. 7 is an illustrative screen display showing critical resultsassociated with a key notification in accordance with an embodiment ofthe present invention;

FIG. 8 is an illustrative screen display showing an exemplary patientactivity list with an action pane including details to selectedactivities in accordance with an embodiment of the present invention;

FIG. 9 is an illustrative screen display showing rescheduling of anactivity in a patient activity list in accordance with an embodiment ofthe present invention;

FIG. 10 is an illustrative screen display showing the result ofrescheduling of an activity in a patient activity list in accordancewith an embodiment of the present invention;

FIG. 11 is an illustrative screen display showing a patient activitylist in a column view in accordance with an embodiment of the presentinvention;

FIG. 12 is an illustrative screen display showing an action pane havingactivities from multiple cells selected in a patient activity list inaccordance with an embodiment of the present invention;

FIG. 13 is an illustrative screen display including a window showingdetails of an activity selected within a patient activity list inaccordance with an embodiment of the present invention;

FIG. 14 is an illustrative screen display including a window showingdetails of another activity selected with a patient activity list inaccordance with an embodiment of the present invention;

FIG. 15 is an illustrative screen display showing the selection ofactivities for charting in accordance with an embodiment of the presentinvention;

FIG. 16 is an illustrative screen display showing a medicationadministration record accessed from a patient activity list inaccordance with an embodiment of the present invention;

FIG. 17 is an illustrative screen display showing the documentation ofan activity in a medication administration record accessed from apatient activity list in accordance with an embodiment of the presentinvention;

FIG. 18 is an illustrative screen display showing the acknowledgement ofa related result provided in a medication administration record inaccordance with an embodiment of the present invention;

FIG. 19 is an illustrative screen display showing a full view medicationadministration record in accordance with an embodiment of the presentinvention;

FIG. 20 is an illustrative screen display showing an activity navigatorin accordance with an embodiment of the present invention;

FIG. 21 is an illustrative screen display showing assessmentdocumentation with outcome icons in accordance with an embodiment of thepresent invention;

FIG. 22 is an illustrative screen display showing an outcome window inaccordance with an embodiment of the present invention;

FIG. 23 is an illustrative screen display showing completion ofassessment documentation in accordance with an embodiment of the presentinvention; and

FIG. 24 is an illustrative screen display showing an outcome summary inaccordance with an embodiment of the present invention.

DETAILED DESCRIPTION

The subject matter of the present invention is described withspecificity herein to meet statutory requirements. However, thedescription itself is not intended to limit the scope of this patent.Rather, the inventors have contemplated that the claimed subject mattermight also be embodied in other ways, to include different steps orcombinations of steps similar to the ones described in this document, inconjunction with other present or future technologies. Moreover,although the terms “step” and/or “block” may be used herein to connotedifferent components of methods employed, the terms should not beinterpreted as implying any particular order among or between varioussteps herein disclosed unless and except when the order of individualsteps is explicitly described.

Embodiments of the present invention, among other things, providecomputerized methods, systems, and user interfaces for facilitatingclinicians in the management of patient activities. An activity or

task” is an assignment or reminder to the clinician that, for instance,a medication was, or is, to be given, a vital sign was, or is, to bechecked, data was, or is, to be collected, a procedure was, or is, to beperformed, or the like. Activities generally have a time associatedtherewith which may be a particular instance in time or may indicatethat the task is continuous, e.g., an IV medication administered over aperiod of several hours, and specify only an initiation time and/or amonitoring time. Alternatively, if desired, a time associated with anactivity may indicate that an activity is to be performed only as needed(i.e., PRN). Activities are typically generated from orders and specify,with particularity, what is to be done for a patient. Thus, if an orderstates that a patient is to receive four 20 mg doses of medication X,one dose every three hours beginning at 12:00 pm, four activities may begenerated: a first activity at 12:00 pm, a second activity at 3:00 pm, athird activity at 6:00 pm, and a fourth activity at 9:00 pm, eachactivity indicating that 20 mg of medication X are to be administered.

A patient activity list provides a common view for a clinician to reviewall patients assigned to the clinician in conjunction with theactivities for the assigned patients during a particular work period.The activities included in the patient activity list are based on theclinician's role. In some cases, multidisciplinary activities (i.e.,activities for other clinicians) may also be presented in the context ofthe clinician's activities. The patient activity list is designed in amanner to limit the amount of information presented in the common viewto reduce noise, but is fully navigable to allow the clinician to accessfurther information, perform documentation, and perform other actions.The clinician may review, reschedule, and document activities in thecontext of other activities.

Embodiments of the present invention further provide an activitiesnavigator that manages activities the clinician has selected tocomplete. The activity navigator may be used by the clinician to easilyfind where the clinician is among activities the clinician has selectedto complete for a patient. As such, the activity navigator allows theclinician to extend prioritization within the midst of completing theworkflow. Interruptions may be managed by the activities navigator bysaving partially completed activities and allowing the clinician tolater access the activities.

Although embodiments of the present invention will be described hereinas managing patient activities for clinicians generally, embodiments ofthe present invention are best suited to managing patient activities fornurses who are tasked with treating patients in a hospital setting.

Referring to the drawings in general, and initially to FIG. 1 inparticular, an exemplary computing system environment, for instance, amedical information computing system, on which embodiments of thepresent invention may be implemented is illustrated and designatedgenerally as reference numeral 20. It will be understood and appreciatedby those of ordinary skill in the art that the illustrated medicalinformation computing system environment 20 is merely an example of onesuitable computing environment and is not intended to suggest anylimitation as to the scope of use or functionality of the invention.Neither should the medical information computing system environment 20be interpreted as having any dependency or requirement relating to anysingle component or combination of components illustrated therein.

Embodiments of the present invention may be operational with numerousother general purpose or special purpose computing system environmentsor configurations. Examples of well-known computing systems,environments, and/or configurations that may be suitable for use withthe present invention include, by way of example only, personalcomputers, server computers, hand-held or laptop devices, multiprocessorsystems, microprocessor-based systems, set top boxes, programmableconsumer electronics, network PCs, minicomputers, mainframe computers,distributed computing environments that include any of theabove-mentioned systems or devices, and the like.

Embodiments of the present invention may be described in the generalcontext of computer-executable instructions, such as program modules,being executed by a computer. Generally, program modules include, butare not limited to, routines, programs, objects, components, and datastructures that perform particular tasks or implement particularabstract data types. Embodiments of the present invention may also bepracticed in distributed computing environments where tasks areperformed by remote processing devices that are linked through acommunications network. In a distributed computing environment, programmodules may be located in local and/or remote computer storage mediaincluding, by way of example only, memory storage devices.

With continued reference to FIG. 1, the exemplary medical informationcomputing system environment 20 includes a general purpose computingdevice in the form of a server 22. Components of the server 22 mayinclude, without limitation, a processing unit, internal system memory,and a suitable system bus for coupling various system components,including database cluster 24, with the server 22. The system bus may beany of several types of bus structures, including a memory bus or memorycontroller, a peripheral bus, and a local bus, using any of a variety ofbus architectures. By way of example, and not limitation, sucharchitectures include Industry Standard Architecture (ISA) bus, MicroChannel Architecture (MCA) bus, Enhanced ISA (EISA) bus, VideoElectronic Standards Association (VESA) local bus, and PeripheralComponent Interconnect (PCI) bus, also known as Mezzanine bus.

The server 22 typically includes, or has access to, a variety ofcomputer readable media, for instance, database cluster 24. Computerreadable media can be any available media that may be accessed by server22, and includes volatile and nonvolatile media, as well as removableand non-removable media. By way of example, and not limitation, computerreadable media may include computer storage media and communicationmedia. Computer storage media may include, without limitation, volatileand nonvolatile media, as well as removable and nonremovable mediaimplemented in any method or technology for storage of information, suchas computer readable instructions, data structures, program modules, orother data. In this regard, computer storage media may include, but isnot limited to, RAM, ROM, EEPROM, flash memory or other memorytechnology, CD-ROM, digital versatile disks (DVDs) or other optical diskstorage, magnetic cassettes, magnetic tape, magnetic disk storage, orother magnetic storage device, or any other medium which can be used tostore the desired information and which may be accessed by the server22. Communication media typically embodies computer readableinstructions, data structures, program modules, or other data in amodulated data signal, such as a carrier wave or other transportmechanism, and may include any information delivery media. As usedherein, the term “modulated data signal” refers to a signal that has oneor more of its attributes set or changed in such a manner as to encodeinformation in the signal. By way of example, and not limitation,communication media includes wired media such as a wired network ordirect-wired connection, and wireless media such as acoustic, RF,infrared, and other wireless media. Combinations of any of the abovealso may be included within the scope of computer readable media.

The computer storage media discussed above and illustrated in FIG. 1,including database cluster 24, provide storage of computer readableinstructions, data structures, program modules, and other data for theserver 22.

The server 22 may operate in a computer network 26 using logicalconnections to one or more remote computers 28. Remote computers 28 maybe located at a variety of locations in a medical or researchenvironment, for example, but not limited to, clinical laboratories,hospitals and other inpatient settings, veterinary environments,ambulatory settings, medical billing and financial offices, hospitaladministration settings, home health care environments, and clinicians'offices. Clinicians may include, but are not limited to, a treatingphysician or physicians, specialists such as surgeons, radiologists,cardiologists, and oncologists, emergency medical technicians,physicians' assistants, nurse practitioners, nurses, nurses' aides,pharmacists, dieticians, microbiologists, laboratory experts, geneticcounselors, researchers, veterinarians, students, and the like. Theremote computers 28 may also be physically located in non-traditionalmedical care environments so that the entire health care community maybe capable of integration on the network. The remote computers 28 may bepersonal computers, servers, routers, network PCs, peer devices, othercommon network nodes, or the like, and may include some or all of thecomponents described above in relation to the server 22. The devices canbe personal digital assistants or other like devices.

Exemplary computer networks 26 may include, without limitation, localarea networks (LANs) and/or wide area networks (WANs). Such networkingenvironments are commonplace in offices, enterprise-wide computernetworks, intranets, and the Internet. When utilized in a WAN networkingenvironment, the server 22 may include a modem or other means forestablishing communications over the WAN, such as the Internet. In anetworked environment, program modules or portions thereof may be storedin the server 22, in the database cluster 24, or on any of the remotecomputers 28. For example, and not by way of limitation, variousapplication programs may reside on the memory associated with any one ormore of the remote computers 28. It will be appreciated by those ofordinary skill in the art that the network connections shown areexemplary and other means of establishing a communications link betweenthe computers (e.g., server 22 and remote computers 28) may be utilized.

In operation, a user may enter commands and information into the server22 or convey the commands and information to the server 22 via one ormore of the remote computers 28 through input devices, such as akeyboard, a pointing device (commonly referred to as a mouse), atrackball, or a touch pad. Other input devices may include, withoutlimitation, microphones, satellite dishes, scanners, or the like.Commands and information may also be sent directly from a remotehealthcare device to the server 22. In addition to a monitor, the server22 and/or remote computers 28 may include other peripheral outputdevices, such as speakers and a printer.

Although many other internal components of the server 22 and the remotecomputers 28 are not shown, those of ordinary skill in the art willappreciate that such components and their interconnection are wellknown. Accordingly, additional details concerning the internalconstruction of the server 22 and the remote computers 28 are notfurther disclosed herein.

Embodiments of the present invention will now be described withreference to FIGS. 2-24, which include exemplary screen displays. Itwill be understood and appreciated by those of ordinary skill in the artthat the screen displays of FIGS. 2-24 are provided by way of exampleonly and are not intended to limit the scope of the present invention inany way.

Referring now to FIG. 2, a screen display is provided illustrating anexemplary patient activity list 200 in accordance with an embodiment ofthe present invention. The patient activity list 200 is populated withthe patients that have been assigned to a given clinician and allows theclinician to view the various activities associated with those patients.Activities are presented in the patient activity list with an icon andnumber to indicate the type of activity and associated number of thattype of activity. Accordingly, a full view of activities across theclinician's assigned patients is provided. This allows the clinician toorganize and prioritize his/her shift. The activities included in thepatient activity list include activities that are relevant to theclinician's role. For example, the patient activity list 200 in FIG. 2is provided for an ICU nurse, Jan Carter. Accordingly, the activitiesincluded are those relevant to an ICU nurse and include, for instance,medications that need to be administered, patient care items,assessments, and specimen collection activities. As another example,activities relevant for a respiratory therapist would include, forinstance, ventilator checks. This activity is typically relevant only totherapists who are assigned that activity.

As shown in FIG. 2, the patient activity list 200 provides a timelineview 202 showing when patients have care-needed activities due.Typically, the timeline will include the entire shift for the clinician.For example, a bold, vertical line 204 is provided in the patientactivity list 200 to indicate when the clinician's shift ends. In thepresent embodiment shown in FIG. 2, the timeline is segregated into timeperiods by hours. However, the timeline may be divided by any timeinterval within various embodiments of the present invention. An ad hoccolumn 206 is also provided to indicate any activities that do not havean associated time. For example, as-needed medications, such as painmedications, may be included in the ad hoc column 206. Additionally, anoverdue column 208 is provided to indicate any overdue activities.

An indication is provided for each column (overdue activities column208, ad hoc column 206, and each time period column in the timeline view202) showing the total number of activities for all patients for thatcolumn. For example, an indication of two total activities is providedfor overdue activities 208, an indication of six total activities isprovided for ad hoc activities 206, and an indication of twelve totalactivities is provided for the 0700 time period 210. Accordingly, theclinician may readily identify slower and busier periods of the shiftand prioritize as necessary. Further, an indication may also be providedto identify the current time period. For instance, the column for the0700 time period 210 has been highlighted and an indication of “Now” hasbeen provided in the patient activity list 200 to indicate that it isthe current time period.

In some embodiments, the patient activity list 200 may also provide anindication of when a patient will be off the clinician's unit. Forexample, the cells corresponding with the patient, Sally Sweetwater, andthe time periods, 1400 through 1600, have been highlighted to indicatethat the patient is off the unit during that time period for surgery,consult, procedure, etc. In some embodiments, the clinician may selectthat time period to access information associated with the patient'slocation during that time. As such, the clinician can view whenactivities do not need to be done for the patient, can prepare for thepatient to leave the unit (e.g., prepping the patient for surgery),and/or can prepare for the patients return to unit (e.g., patient mayneed increased pain medication returning from surgery). Additionally,the clinician can balance his/her workload and complete activities forother patients while the patient is off the unit.

The patient activity list 200 is organized in a simplified manner thatallows the clinician to readily identify patient activities while notbeing overloaded with extraneous information. For example, graphicalicons are used to represent activities, critical indicators (which willbe described in further detail below), and other miscellaneous items.The legend at the bottom of the screen provides definitions for thevarious icons. In particular, the legend provides definitions forcritical indicator icons 212, activity icons 214, and othermiscellaneous item icons 216. It will be appreciated that any variety oficons may be utilized. Although the patient activity list 200 limits theamount of information included in the normal view, the patient activitylist 200 is fully navigable allowing the clinician to access furtherinformation as necessary, as well as to reschedule and documentactivities.

Patient information is provided in the patient activity list 200 foreach of the clinician's patients. To reduce noise, typically onlygeneral patient information is provided in the patient informationsection. For example, in FIG. 2, the patient information includes apatient name, age, sex, medical condition, and an acuity score.Additionally, the patient's location, such as a hospital room number, isprovided. In some embodiments, only a patient name or identifier may beincluded in a patient activity list, while in other embodiments, moredetailed information may be included.

In conjunction with the general patient information, critical indicators218 may be provided with each patient. The critical indicators providean indication of critical information associated with each patient. Byway of example only and not limitation, the critical indicators mayinclude information associated with allergies, code status, isolation,and other vitally important information associated with each patient.

As shown in FIG. 2, zero or more critical indicator icons are providedwith each patient. A clinician may quickly identify the type of criticalindicator associated with an icon by referring to the critical indicatordefinitions 212 at the bottom of the display. A clinician may alsoaccess specific information associated with a particular patient'scritical indicators by selecting that patient's critical indicators. Forexample, by viewing the patient activity list, the clinician recognizesthat there are two critical indicators associated with her patient,Charles Adams, including critical information and allergies, and maywish to review specifics regarding these critical indicators. When theclinician selects the critical indicators 220, the critical indicatorwindow 302 shown in FIG. 3 is presented. As shown in FIG. 3, thecritical indicator window 302 includes information associated with boththe critical information and allergy critical indicators for thepatient. More specifically, the critical indicator window 302 includescritical information indicating that no information is to be releasedfor the patient and that the patient is a VIP. Additionally, thecritical indicator window 302 provides information indicating that thepatient is allergic to codeine. In some cases, the critical indicatorwindow 302 may allow a clinician to add additional informationassociated with critical indicators. For example, the critical indicatorwindow 302 provides a link to allow the clinician to add additionalallergies if any are determined.

In some cases, a clinician may wish to access further informationassociated with a patient in addition to the information displayed inthe patient activity list. Typically, this would require a clinician toenter the patient's chart to find the desired information. However, thepatient's chart often includes a large amount of information, therebyrequiring the clinician to search numerous sections of the chart to findthe desired information. Embodiments of the present invention provide apatient snapshot that includes relevant information for the patient. Thepatient snapshot includes information that the clinician may wish tofrequently and/or quickly access. Currently, nurses often manuallyrecord vital patient information on a note card or other slip of paper,which is often referred to as the nurse's “brain.” The “brain” allowsthe nurse to quickly find vital patient information. Additionally, the“brain” provides a convenient way for a nurse to transfer and exchangeimportant information to an incoming nurse during a shift change.Accordingly, the patient snapshot in accordance with embodiments of thepresent invention provides an electronic version of such a nurse's“brain” by capturing and providing quick access to vital patientinformation and comments.

A clinician may view a patient snapshot by selecting a patient from apatient activity list. For example, when the clinician selects thepatient, Charles Adams, in the patient activity list 200 of FIG. 2, thepatient snapshot 402 shown in FIG. 4 is presented within the display.The patient snapshot 402 may include a variety of pieces of relevantpatient information, such as, for example, admission information,alerts, workload information, plan summary, vitals, critical results IVinformation, invasive devices, monitors, healthcare provider/physicians,medication information, pending orders, and comments associated with thepatient.

As shown in FIG. 4, the patient snapshot 402 is presented in conjunctionwith the timeline of activities for the associated patient. This allowsthe clinician to view the snapshot information in the context of thedaily activities for the patient. Typically, information associated withpatients other than the currently selected patient may be removed fromthe display to provide space for the patient snapshot 402. However, if alimited number of patients are associated with a clinician or sufficientscreen space is otherwise available, the patient snapshot may bepresented in the display without removing the other patients from thepatient activity list.

Although the patient snapshot provides a convenient way for a clinicianto quickly access the most frequently needed and/or relevant informationfor a patient, in some cases, a clinician may need to access furtherinformation not included in the patient snapshot. Accordingly, as shownin FIG. 4, the snapshot window 402 includes a link 404 to a chartoverview. By selecting the link, the clinician may be navigated to thatpatient's chart, such as that shown in FIG. 5. The clinician may thennavigate the patient's chart to find desired information.

Referring again to FIG. 2, in addition to providing an indication ofpatient activities for the clinician, the patient activity list 200 alsoincludes a key notification area 222. Key notifications are furtherdescribed in U.S. patent application Ser. No. 11/427,623, filed on Jun.29, 2006, which is herein incorporated by reference in its entirety.Generally, key notifications include electronic notifications of newtime-sensitive or otherwise important items of information that havebeen received for a patient. For instance, the key notification area 222includes key notifications for critical results 224, new orders 226, newactivities 228, and plan changes 230. The key notifications included fora particular patient activity list will depend on the role of theclinician. For example, critical results that need to be reviewed by aphysician may not be important to a nurse and would not be included inthe nurse's key notifications. Conversely, key notifications specific tonursing are those orders that require nurse review, such as a change ina patient's plan of care with modified expected outcomes. This type ofnotification would be specific to the nurse caring for the patient, butmay not be relevant to any other clinician.

The key notification area 222 allows the clinician to quickly identifynew key notifications and to navigate to the associated information. Forexample, when a clinician selects the critical results notification area224, an inbox 600 may be presented such as that shown in FIG. 6. Inparticular, because the clinician selected the critical resultsnotification area 224 in FIG. 2, new critical results are presentedwithin the inbox in FIG. 6. The clinician may select an item, such asthe critical result 602 for Charles Adams, to view the relevantinformation as shown in FIG. 7. For example, the laboratory results,including the sodium level, potassium level, and B Natriuretic peptide,for Charles Adams are complete. These levels are important for aclinician such as a nurse to see promptly when caring for a patient.Once the clinician verifies that the item has been reviewed and/or anynecessary actions have been taken, the item is removed from the keynotifications area 222 of FIG. 2.

The patient activity list 200 of FIG. 2 allows a clinician to viewactivities associated with assigned patients. Additionally, theclinician may employ the patient activity list 200 to access informationassociated with various activities, reschedule activities, and documentactivities as they are completed. To view information associated withactivities, the clinician may select one or more cells within thepatient activity list 200. For example, by selecting the cell associatedwith the patient, Charles Adams, and the 0800 time period, the screendisplay shown in FIG. 8 is provided. In particular, an action pane 802is provided showing activities for Charles Adams scheduled for the 0800time period. In various embodiments, a clinician may select multiplecells and view all activities from those cells within the action pane.For instance, the clinician may have selected the cells associated withthe patient, Charles Adams, and both the 0700 and 0800 time periods toview all activities during those time periods.

As shown in FIG. 8, the action pane 802 is provided with the timelineview of activities for the corresponding patient, thereby allowing theclinician to view activity particulars in context of all activities forthat patient. Typically, other patients within that patient activitylist are removed such as shown in FIG. 8. However, it should be notedthat, in some embodiments, other patients may remain within the display.

The action pane 802 provides information associated with the activitieswithin the selected cell of the patient activity list. In FIG. 8, theaction pane includes two medication activities, one patient careactivity, and three assessment activities. In some case, furtherinformation, such as evidence-based data, may be available to theclinician for a particular activity. For instance, the digoxin activity804 includes a reference data item 806. If the clinician selects thereference data item 806, a reference slider 808 is provided with a linkto further information.

Additionally, as shown in FIG. 8, multidisciplinary activities 810 for agiven patient may be shown within the patient activity list. Themultidisciplinary activities include those activities that are to beperformed for the patient by other clinicians, such as, for example,respiratory therapists, physical therapists, and occupationaltherapists. By viewing activities scheduled to be completed for apatient by other clinicians, the clinician may prioritize whenactivities are performed to prevent a conflict with other clinicians'activities.

In some cases, a clinician may wish to reschedule a scheduled activity.For instance, when the clinician reviews the patient activity list shownin FIG. 8, the clinician may recognize that it may be difficult toperform all six activities scheduled for the patient during the 0800time period when there is also a multidisciplinary activity scheduledduring that time period. Accordingly, the clinician may reschedule oneor more activities using the action pane 802. For instance, theclinician may wish to reschedule the medication activity for digoxin804. By selecting the reschedule icon 812 associated with that item, areschedule dialog box 902 such as that shown in FIG. 9 is presented. Thereschedule dialog box 902 allows the clinician to reschedule theactivity to another time period. For example, the clinician hasindicated a reschedule to the 0900 time period. Additionally, thereschedule dialog box 902 prompts the clinician to provide a reason forthe reschedule. A reschedule history may also be maintained to trackrescheduling of the activities. Accordingly, the reschedule history forthe activity is presented in the reschedule dialog box 902. Activityreschedule histories may also be accessed by other personnel for safety,audit, and accounting purposes. For example, a charge nurse may accessreschedule histories to detect any inappropriate rescheduling by nurses.

After the clinician indicates a reschedule time period and a reason, theclinician may select the “OK” button 904 in the dialog box. As shown inFIG. 10, the digoxin activity no longer appears in the action pane.Additionally, only one medication activity is now shown for the 0800time period, and one medication activity is now shown for the 0900 timeperiod. Accordingly, the clinician may reschedule activities whileviewing an entire timeline for the patient such that rescheduling may beperformed in context of the activities for the patient.

In some cases, a clinician may wish to focus on all activities acrossassigned patients for a given time period. Accordingly, a column may beselected for review. For example, if the clinician selects the 1000 timeperiod column in the patient activity list 200 of FIG. 2, the filteredpatient activity list 1100 of FIG. 11 may be provided. In particular, asshown in FIG. 11, only those patients that have activities during theselected time period are shown in the patient activity list. Otherpatients are removed to simplify the view. Additionally, further detailsregarding each of the activities for that time period are provided. Asshown in FIG. 11, instead of including only an icon for each activityduring the 1000 time period, details of each activity are provided. Forexample, the specimen collect activity for the patient, Sally Sweetwateris indicated as a urine analysis. The column view allows the clinicianto focus on the activities for the scheduled time period to assist inprioritization and organization of the activities.

As indicated previously, a clinician may select multiple cells to viewall activities associated with those cells. For instance, referring nowto the patient activity list 1200 of FIG. 12, the clinician has selectedthe cells for Charles Adams corresponding with both the ad hocactivities 1202 and the 0900 activities 1204. Accordingly, allactivities associated with these cells are provided in the action pane1206.

In some cases, further information may be accessed by selecting anactivity within an action pane. For instance, when the clinician selectsthe morphine activity 1208 in FIG. 12, the window 1302 shown in FIG. 13is provided. In particular, information is provided indicating when thelast dose of morphine was administered, as well as the time when thenext dose of morphine may be administered. As another example, when theclinician selects the digoxin activity 1210 in FIG. 12, the window 1402shown in FIG. 14 is provided. In particular, the window 1402 providesinformation including last administered dose, reschedule history,administration comments, and access to reference information.

An action pane may also assist the clinician in performing activitiesand documenting the completion of activities. For example, referring toFIG. 15, the clinician may select the activities in the action pane 1502that the clinician wishes to perform and document by checking a chartbox for each of such activities. As shown in FIG. 15, the clinician hasselected to chart the digoxin activity 1504, furosemide activity 1506,dobutamine activity 1508, insulin activity 1510, respiratory assessmentactivity 1512, I&O activity 1514, and patient safety checks activity1516. In some cases, safety checks may be provided to prevent aclinician from performing and charting an activity. For instance, thechart box 1518 for the morphine activity 1520 has been disabled. Inparticular, as shown in the morphine activity details window 1302 ofFIG. 13, morphine was recently administered and cannot be administeredagain until a later time.

After selecting activities in the action pane 1502 to perform and chart,the “OK” button 1522 may be selected and charting for all the selectedactivities is initiated. In particular, the clinician is navigated to anappropriate documentation solution. For example, the first activity inthe action pane 1502 is the digoxin activity 1504, which is a medicationactivity. Accordingly, the user is navigated to a medicationadministration record (MAR) 1600 for the patient as shown in FIG. 16. Inparticular, an activity view MAR is provided that is specific to thedigoxin medication for the patient. The activity view MAR allows theclinician to document within context. For example, a timeline 1602 isincluded providing an indication of when the medication is due.Additionally, the activity view MAR includes a results and documentationarea 1604. Any results relevant to the administration of a medicationare included in the results and documentation area 1604. For instance,heart rate and serum potassium level are relevant to the administrationof digoxin, and, as such, heart rate and serum potassium level resultsare presented in the results and documentation area 1604. In some cases,the clinician may need to monitor the patient and provide results tocontinue documentation. After reviewing the related results, theclinician takes the patient's heart rate and administers the digoxin.Referring to FIG. 17, the clinician documents the patient's heart rateand details of the medication administration.

In some embodiments, a clinician may use a related result whendocumenting an activity. For example, referring now to FIG. 18, anactivity view MAR 1800 is presented for insulin. As shown in FIG. 18,related results for the administration of insulin is a finger stickglucose. When the clinician prepares to administer insulin to thepatient, the clinician may review the activity view MAR 1800 andrecognize that the related result indicates that the finger stickglucose was recently taken for the patient. Accordingly, instead oftaking a new finger stick glucose and inserting its results, theclinician may acknowledge the related result in the activity view MAR byselecting the acknowledge box 1802. Accordingly, this related result isused for documentation purposes for the insulin administration.

The clinician may further toggle between an activity view MAR and a fullview MAR. For example, turning to FIG. 19, a full view MAR 1900 for thepatient, Charles Adams, is shown. The full view MAR 1900 may beprovided, for instance, by the clinician selecting the “Full View”button 1902. As shown in FIG. 19, the full view MAR allows the clinicianto view all medication activities for the patient within context of oneanother for a specified time period.

At any time, a clinician may view activities that the clinician hasselected to document by accessing an activity navigator. This isparticularly useful as clinicians are often interrupted while performingand documenting activities. The activity navigator allows a clinician toquickly and easily resume any interrupted activities. For example, ifthe clinician were interrupted while attempting to complete anassessment of a patient, the clinician may easily return to theassessment with all information previously entered in the assessmentdocumentation having been saved.

Referring to FIG. 20, a screen display is provided showing an exemplaryactivity navigator 2002 in accordance with an embodiment of the presentinvention. As shown in FIG. 20, the activity navigator 2002 indicateseach of the activities that the clinician has selected to chart but hasnot yet completed. By selecting an activity from the activity navigator2002, the clinician is navigated to the appropriate documentationsolution to allow the clinician to continue documenting that activity.

For example, the clinician may decide to select respiratory assessmentand patient safety checks 2004, 2006 from the activity navigator in FIG.20. Based on the selection, the appropriate documentation solution forthese assessments is presented to the clinician as shown in FIG. 21. Asshown in FIG. 21, the clinician may enter information for the currentassessment in context of previous assessments.

Additionally shown in FIG. 21 are a number of outcome icons 2102, 2104,2106 that are provided for particular assessment items. The outcomeicons 2102, 2104, 2106 provide access to information associated with apatient's plan of care. Typically, a plan of care may be developed for apatient that sets forth a number of outcomes or goals for the patientthroughout the care process. Embodiments of the present invention pushthese outcomes to the documentation workflow. Accordingly, the clinicianmay review outcomes from the patient's plan of care while documentingassessment. For example, when the clinician selects the outcome icon2102, the outcome window 2202 shown in FIG. 22 is provided.

After reviewing outcomes within the documentation, the clinician maycomplete the assessment documentation as shown in FIG. 23. Aftercompleting the documentation, the system may compare the providedassessment information against outcomes from the plan of care toidentify met and unmet outcomes. Based on the comparison, the system mayprovide the summary window 2402 shown in FIG. 24. As shown in FIG. 24,the summary window 2402 provides an indication of met and unmetoutcomes. In some embodiments, the summary may be pushed to otherclinicians based on role. Additionally, in some embodiments, unmetoutcomes may be identified within the patient activity list, therebyallowing the clinician to view the unmet outcomes in the context ofother activities for the patient.

As can be understood, embodiments of the present invention provide anapproach to facilitate the management of activities for a clinician. Thepresent invention has been described in relation to particularembodiments, which are intended in all respects to be illustrativerather than restrictive. Alternative embodiments will become apparent tothose of ordinary skill in the art to which the present inventionpertains without departing from its scope.

From the foregoing, it will be seen that this invention is one welladapted to attain all the ends and objects set forth above, togetherwith other advantages which are obvious and inherent to the system andmethod. It will be understood that certain features and subcombinationsare of utility and may be employed without reference to other featuresand subcombinations. This is contemplated and within the scope of theclaims.

1. A method for providing outcome information associated with a patientplan of care in conjunction with documentation of assessment items for apatient, the method comprising: presenting a documentation area fordocumenting one or more assessment items for the patient, thedocumentation area having one or more areas for entering patientassessment information for the one or more assessment items; presentingan outcome icon in conjunction with at least one assessment item, theoutcome icon relating to at least one outcome corresponding with the atleast one assessment item and being based on the patient plan of care;receiving a user selection of the outcome icon; and presentinginformation associated with the at least one outcome in context of thedocumentation area.
 2. The method of claim 1, wherein the documentationarea includes historical patient assessment information for the one ormore assessment items.
 3. The method of claim 1, wherein presenting anoutcome icon in conjunction with at least one assessment item comprisesidentifying at least one outcome from the patient plan of carecorresponding with the at least one assessment item.
 4. The method ofclaim 1, wherein the method further comprises receiving patientassessment information for at least one assessment item correspondingwith an outcome from the patient plan of care.
 5. The method of claim 4,wherein receiving patient assessment information for at least oneassessment item comprises receiving the patient assessment informationfrom a clinician performing the at least one assessment item.
 6. Themethod of claim 4, wherein the method further comprises comparing thereceived patient assessment information against the correspondingoutcome to determine whether the outcome has been met.
 7. The method ofclaim 6, wherein the method further comprising presenting an indicationregarding whether the outcome has been met.
 8. One or morecomputer-readable media embodying computer-useable instructions forperforming a method for facilitating documentation of patient assessmentitems, the method comprising: identifying an outcome from a patient planof care corresponding with a patient assessment item requiringdocumentation for the patient; and providing information associated withthe outcome in context of documentation of the patient assessment item.9. The one or more computer-readable media of claim 8, wherein themethod further comprises receiving documentation information for thepatient assessment item.
 10. The one or more computer-readable media ofclaim 9, wherein receiving documentation information for the patientassessment item comprises receiving the documentation information from aclinician performing the patient assessment item.
 11. The one or morecomputer-readable media of claim 9, wherein the method further comprisescomparing the documentation information with the outcome from thepatient plan of care to determine whether the outcome has been met. 12.The one or more computer-readable media of claim 11, wherein the methodfurther comprises presenting an indication regarding whether the outcomehas been met.
 13. The method of claim 8, wherein providing informationassociated with the outcome in context of documentation of the patientassessment item comprises presenting historical patient assessmentinformation for the patient assessment item.
 14. A method in a clinicalcomputing environment for determining whether an outcome from a patientplan of care has been met for a patient, the method comprising:receiving patient assessment information for a patient assessment item;comparing the patient assessment information against one or moreoutcomes from a patient plan of care; determining whether each outcomehas been met; and presenting an indication whether each outcome has beenmet.
 15. The method of claim 14, wherein receiving patient assessmentinformation comprises receiving patient assessment information from aclinician via a documentation user interface that includes an areaallowing a clinician to enter the patient assessment information. 16.The method of claim 15, wherein the documentation user interfacepresents information associated with at least one of the one or moreoutcomes in conjunction with the area allowing a clinician to enter thepatient assessment information.
 17. The method of claim 15, wherein thedocumentation user interface further includes historical patientassessment information for the patient assessment item.
 18. The methodof claim 14, wherein presenting an indication whether each outcome hasbeen met comprises at least one of presenting the indication to aclinician performing the patient assessment information andcommunicating the indication to one or more other clinicians.
 19. Themethod of claim 14, wherein presenting an indication whether eachoutcome has been met comprises presenting an outcome indication in apatient activity list facilitating management of activities for aclinician, the activities includes patient assessment activities.